Abstract
Objectives: The authors hypothesized that the women enrolled in the HF-ACTION (Heart Failure-A Controlled Trial Investigating Outcomes of Exercise TraiNing) trial and randomly assigned to exercise training (ET) would improve functional capacity as measured by peak oxygen uptake (VO2) compared with those in the usual care group. Furthermore, they hypothesized that the improvement in peak VO2 would correlate with prognosis. They explored whether exercise had a differential effect on outcomes in women versus men. Background: There is less evidence for the benefit of ET in women with heart failure (HF) compared with men because of the small numbers of women studied. Methods: HF-ACTION was a randomized trial of ET versus usual care in 2,331 patients with class II-IV HF and a left ventricular ejection fraction of≤35%. Sex differences in the effects of randomized treatment on clinical outcomes were assessed through the use of a series of Cox proportional hazards models, controlling for covariates known to affect prognosis in HF-ACTION. Results: Women had lower baseline peak VO2 and 6-min walk distance than did men (median, 13.4 vs. 14.9 ml/min/kg and 353 vs. 378 m, respectively). An increase in peak VO2 at 3 months was present in women and men in the ET group (mean ± SD; median, 0.88 ± 2.2, 0.80 and 0.77 ± 2.7, 0.60, respectively, women vs. men; p= 0.42). Women randomly assigned to ET had a significant reduction in the primary endpoint, (hazard ratio: 0.74) compared with men (hazard ratio: 0.99) randomly assigned to ET, with a significant treatment-by-sex interaction (p= 0.027). Conclusions: Although there is no significant difference between men and women in the effect of ET on peak VO2 change at 3months, ET in women with HF is associated with a larger reduction in rate of the combined endpoint of all-cause mortality and hospital stay than in men.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 180-186 |
| Number of pages | 7 |
| Journal | JACC: Heart Failure |
| Volume | 2 |
| Issue number | 2 |
| DOIs | |
| State | Published - 2014 |
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Keywords
- Cardiopulmonary exercise testing
- Exercise training
- Heartfailure
- Women
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Medicine(all)
Cite this
Effects of exercise training on outcomes inwomen with heart failure. Analysis of HF-ACTION (Heart failure-a controlled trialinvestigating outcomes of exercise training) by Sex. / Pina, Ileana L.; Bittner, Vera; Clare, Robert M.; Swank, Ann; Kao, Andrew; Safford, Robert; Nigam, Anil; Barnard, Denise; Walsh, Mary N.; Ellis, Stephen J.; Keteyian, Steven J.
In: JACC: Heart Failure, Vol. 2, No. 2, 2014, p. 180-186.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effects of exercise training on outcomes inwomen with heart failure. Analysis of HF-ACTION (Heart failure-a controlled trialinvestigating outcomes of exercise training) by Sex
AU - Pina, Ileana L.
AU - Bittner, Vera
AU - Clare, Robert M.
AU - Swank, Ann
AU - Kao, Andrew
AU - Safford, Robert
AU - Nigam, Anil
AU - Barnard, Denise
AU - Walsh, Mary N.
AU - Ellis, Stephen J.
AU - Keteyian, Steven J.
PY - 2014
Y1 - 2014
N2 - Objectives: The authors hypothesized that the women enrolled in the HF-ACTION (Heart Failure-A Controlled Trial Investigating Outcomes of Exercise TraiNing) trial and randomly assigned to exercise training (ET) would improve functional capacity as measured by peak oxygen uptake (VO2) compared with those in the usual care group. Furthermore, they hypothesized that the improvement in peak VO2 would correlate with prognosis. They explored whether exercise had a differential effect on outcomes in women versus men. Background: There is less evidence for the benefit of ET in women with heart failure (HF) compared with men because of the small numbers of women studied. Methods: HF-ACTION was a randomized trial of ET versus usual care in 2,331 patients with class II-IV HF and a left ventricular ejection fraction of≤35%. Sex differences in the effects of randomized treatment on clinical outcomes were assessed through the use of a series of Cox proportional hazards models, controlling for covariates known to affect prognosis in HF-ACTION. Results: Women had lower baseline peak VO2 and 6-min walk distance than did men (median, 13.4 vs. 14.9 ml/min/kg and 353 vs. 378 m, respectively). An increase in peak VO2 at 3 months was present in women and men in the ET group (mean ± SD; median, 0.88 ± 2.2, 0.80 and 0.77 ± 2.7, 0.60, respectively, women vs. men; p= 0.42). Women randomly assigned to ET had a significant reduction in the primary endpoint, (hazard ratio: 0.74) compared with men (hazard ratio: 0.99) randomly assigned to ET, with a significant treatment-by-sex interaction (p= 0.027). Conclusions: Although there is no significant difference between men and women in the effect of ET on peak VO2 change at 3months, ET in women with HF is associated with a larger reduction in rate of the combined endpoint of all-cause mortality and hospital stay than in men.
AB - Objectives: The authors hypothesized that the women enrolled in the HF-ACTION (Heart Failure-A Controlled Trial Investigating Outcomes of Exercise TraiNing) trial and randomly assigned to exercise training (ET) would improve functional capacity as measured by peak oxygen uptake (VO2) compared with those in the usual care group. Furthermore, they hypothesized that the improvement in peak VO2 would correlate with prognosis. They explored whether exercise had a differential effect on outcomes in women versus men. Background: There is less evidence for the benefit of ET in women with heart failure (HF) compared with men because of the small numbers of women studied. Methods: HF-ACTION was a randomized trial of ET versus usual care in 2,331 patients with class II-IV HF and a left ventricular ejection fraction of≤35%. Sex differences in the effects of randomized treatment on clinical outcomes were assessed through the use of a series of Cox proportional hazards models, controlling for covariates known to affect prognosis in HF-ACTION. Results: Women had lower baseline peak VO2 and 6-min walk distance than did men (median, 13.4 vs. 14.9 ml/min/kg and 353 vs. 378 m, respectively). An increase in peak VO2 at 3 months was present in women and men in the ET group (mean ± SD; median, 0.88 ± 2.2, 0.80 and 0.77 ± 2.7, 0.60, respectively, women vs. men; p= 0.42). Women randomly assigned to ET had a significant reduction in the primary endpoint, (hazard ratio: 0.74) compared with men (hazard ratio: 0.99) randomly assigned to ET, with a significant treatment-by-sex interaction (p= 0.027). Conclusions: Although there is no significant difference between men and women in the effect of ET on peak VO2 change at 3months, ET in women with HF is associated with a larger reduction in rate of the combined endpoint of all-cause mortality and hospital stay than in men.
KW - Cardiopulmonary exercise testing
KW - Exercise training
KW - Heartfailure
KW - Women
UR - http://www.scopus.com/inward/record.url?scp=84897576721&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84897576721&partnerID=8YFLogxK
U2 - 10.1016/j.jchf.2013.10.007
DO - 10.1016/j.jchf.2013.10.007
M3 - Article
C2 - 24720927
AN - SCOPUS:84897576721
VL - 2
SP - 180
EP - 186
JO - JACC: Heart Failure
JF - JACC: Heart Failure
SN - 2213-1779
IS - 2
ER -